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Abstract: TH-PO169

Triglyceride to HDL-Cholesterol Ratio and Risk of Major Cardiovascular Events in Renal Transplantation Recipients

Session Information

Category: Transplantation

  • 1802 Transplantation: Clinical


  • Kim, Ji Eun, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Yu, Mi-yeon, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kim, Yong Chul, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Lee, Jung Pyo, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Lee, Hajeong, Seoul National University Hospital, Seoul, Korea (the Republic of)

Dyslipidemia is common in renal transplant recipients(RTRs). Recent studies have shown that TG/HDL-C ratio may be a better predictor of cardiovascular(CV) events and CV mortality than other lipid parameters. We analyzed the TG/HDL of the first year of transplantation to identify the risk factors for major cardiovascular events(MACE). MACE was defined as heart failure, coronary artery disease with percutaneous coronary artery intervention(PCI), and cerebrovascular disease confirmed as an imaging study.


We retrospectively included 1301 RTRs who had lipid profile after 1 year of transplantation between 2000-2018. We identified TG/HDL from the lipid profile at 1 year and classified it into 3 groups as follows: low; less than 1, moderate; 1 to 2.5, high; 2.5 or more. After then, we explored an association between TG/HDL group and MACE.


The mean age of included patients was 40.9 years and male sex was 61.7%. The prevalence of diabetes was 29.1%. Statin was prescribed in 30.3% of RTRs within 1 year after transplantation. RTRs with higher TG/HDL tended to be more men, more obese and diabetic. Proportion receiving statin was lowest in moderate TG/HDL group. During follow-up, 80 patients experienced MACE. Time to MACE occurrence was 92.7 month. As expected high TG/HDL group showed elevated MACE risk even after adjustment with age, sex, BMI, DM, prior history of CVD, and statin use (adjusted HR 1.98 [1.20-3.29] p=0.008), compared with moderate TG/HDL group. Interestingly, also low TG/HDL group revealed higher risk of MACE, compared to moderate TG/HDL group (adjusted HR 2.14[1.03-4.47] p=0.041). These associations were represented similarly in statin users, whereas only low TG/HDL group, not high TG/HDL group, showed elevated MACE risk in non-statin users.


High TG/HDL of 2.5 or more may be a risk factor for cardiovascular events in RTRs, especially in patients requiring statin therapy. Additionally, our study suggested low TG/HDL may paradoxically increase cardiovascular risk, especially in low risk patients.